iron absorption from complementary food fortificants (cffs) and acceptability of cffs by beninese children

Conditions: Iron Deficiency; Anemia

Summary: iron deficiency (id) is still a main public health problem in sub-saharan africa. iron deficient children have an increased risk for anemia which is associated with adverse infant development that might be partly irreversible. in sub-saharan africa, the etiology of id in children is multifactoral; but the major causes are low iron dietary bioavailability and intake from monotonous cereal-based complementary foods. children \< 5 years old can benefit from iron-fortified complementary foods; however, these fortified complementary foods are often not adapted to the requirements of children in specific setting. the investigators developed a complementary food fortificant (cff) which is added to local porridge and is deemed to meet the nutrient intake requirement for iron in children 1-3 years of age. the cff is lipid-based and can therefore, if regularly used, increase the daily energy intake of children which is often too low in developing countries with cereal-based diets. the iron absorption from the mixture of cff and porridge has to be optimized because it contains quite a high amount of phytate, a well-known inhibitor of iron absorption. to optimize iron absorption the investigators are planning three iron absorption studies using different compounds of iron (feso4 + nafeedta), additional vitamin c and phytase, which is able to degrade phytate. in the first study, iron absorption will be determined from a mixture of cff and porridge fortified with 1) 6 mg feso4 and 2) 6 mg feso4 plus additional vitamin c. in the second study, the test meals will be fortified with 1) 6 mg feso4 and 2) a mixture of 3 mg feso4 + 3 mg nafeedta. in the third study, test meals will be fortified with 1) 6 mg feso4, 2) 6 mg feso4 plus phytase, and 3) 6 mg feso4 plus additional vitamin c and phytase. iron absorption will be determined by incorporation of labeled iron into erythrocytes, 14 days after the administration of a test meal containing labeled iron (stable isotope technique). sixty apparently healthy beninese children 12-36 months of age with a body weight \> 8.3 kg will be included in the study. additionally, the investigators will test acceptability of cffs based on different composition formulas by interviewing the parents/legal guardians of the children after feeding the cff for a defined period. the results of these studies will provide important insights to optimize the iron absorption of young children from a cff mixed with local traditional porridge in developing countries. furthermore the studies will provide information on the acceptability of cffs in such a setting.


Eligibility criteria:
inclusion criteria: * female or male children, 12 - 36 months of age * a body weight of at least 8.3 kg; weight for age ≥ -3 z-score * no malaria parasites in the blood smear + negative malaria rapid test * no hematuria * no intake of mineral/vitamin supplements 2 weeks before and during the study * no metabolic or gastrointestinal disorders exclusion criteria: * fever (body temperature \> 37.5 °c) * severe anemia (hemoglobin \< 8.0 g/dl) * regular intake of medication * blood transfusion or significant blood loss (accident, surgery) over the past 4 months * currently participating in another clinical trial or having participated in another clinical trial during the last 3 months prior to the beginning of this study * former participation in a study involving administration of iron stable isotopes * subject who cannot be expected to comply with study protocol * eating disorders or food allergy

Keywords: iron absorption complementary food fortificant young children